Cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders in Singapore

2018 ◽  
Vol 41 (2) ◽  
pp. 391-398
Author(s):  
Monica Teng ◽  
Hui Jun Zhou ◽  
Liang Lin ◽  
Pang Hung Lim ◽  
Doreen Yeo ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Musculoskeletal Disorders ◽  
Cost Effective ◽  
Target Population ◽  
Quality Adjusted Life Year ◽  
Decision Analytic Model ◽  
Published Data ◽  
Total Knee ◽  
The Cost ◽  
Quality Adjusted Life

Abstract Background The study evaluated the cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders (MSDs) in Singapore. Methods A decision-analytic model was constructed to compare the cost-effectiveness of hydrotherapy to land-based therapy over 3 months from societal perspective. Target population comprised patients with low back pain (LBP), osteoarthritis (OA), rheumatoid arthritis (RA), total hip replacement (THR) and total knee replacement (TKR). Subgroup analyses were carried out to determine the cost-effectiveness of hydrotherapy in individual MSDs. Relative treatment effects were obtained through a systematic review of published data. Results Compared to land-based therapy, hydrotherapy was associated with an incremental cost-effectiveness ratio (ICER) of SGD 27 471 per quality-adjusted life-year (QALY) gained, which was below the willingness-to-pay threshold of SGD 70 000 per QALY (one gross domestic product per capita in Singapore in 2015). For the respective MSDs, hydrotherapy were dominant (more effective and less costly) in THR and TKR, cost-effective for LBP and RA, and not cost-effective for OA. Treatment adherence and cost of hydrotherapy were key drivers to the ICER values. Conclusions Hydrotherapy was a cost-effective rehabilitation compared to land-based therapy for a population with MSDs in Singapore. However, the benefit of hydrotherapy was not observed in patients with OA.

scholarly journals The Cost-Effectiveness of Rapid Diagnostic Testing for the Diagnosis of Bloodstream Infections with or without Antimicrobial Stewardship

2018 ◽  
Vol 31 (3) ◽  
Author(s):  
Elina Eleftheria Pliakos ◽  
Nikolaos Andreatos ◽  
Fadi Shehadeh ◽  
Panayiotis D. Ziakas ◽  
Eleftherios Mylonakis
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Decision Analytic Model ◽  
Laboratory Methods ◽  
The Cost ◽  
Quality Adjusted Life

SUMMARYBloodstream infections are associated with considerable morbidity and health care costs. Molecular rapid diagnostic tests (mRDTs) are a promising complement to conventional laboratory methods for the diagnosis of bloodstream infections and may reduce the time to effective therapy among patients with bloodstream infections. The concurrent implementation of antimicrobial stewardship programs (ASPs) may reinforce these benefits. The aim of this study was to evaluate the cost-effectivenesses of competing strategies for the diagnosis of bloodstream infection alone or combined with an ASP. To this effect, we constructed a decision-analytic model comparing 12 strategies for the diagnosis of bloodstream infection. The main arms compared the use of mRDT and conventional laboratory methods with or without an ASP. The baseline strategy used as the standard was the use of conventional laboratory methods without an ASP, and our decision-analytic model assessed the cost-effectivenesses of 5 principal strategies: mRDT (with and without an ASP), mRDT with an ASP, mRDT without an ASP, conventional laboratory methods with an ASP, and conventional laboratory methods without an ASP. Furthermore, based on the availability of data in the literature, we assessed the cost-effectivenesses of 7 mRDT subcategories, as follows: PCR with an ASP, matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) analysis with an ASP, peptide nucleic acid fluorescentin situhybridization (PNA-FISH) with an ASP, a blood culture nanotechnology microarray system for Gram-negative bacteria (BC-GP) with an ASP, a blood culture nanotechnology microarray system for Gram-positive bacteria (BC-GN) with an ASP, PCR without an ASP, and PNA-FISH without an ASP. Our patient population consisted of adult inpatients in U.S. hospitals with suspected bloodstream infection. The time horizon of the model was the projected life expectancy of the patients. In a base-case analysis, cost-effectiveness was determined by calculating the numbers of bloodstream infection deaths averted, the numbers of quality-adjusted life years gained, and incremental cost-effectiveness ratios (ICERs). In a probabilistic analysis, uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds. In the base-case analysis, MALDI-TOF analysis with an ASP was the most cost-effective strategy, resulting in savings of $29,205 per quality-adjusted life year and preventing 1 death per 14 patients with suspected bloodstream infection tested compared to conventional laboratory methods without an ASP (ICER, −$29,205/quality-adjusted life year). BC-GN with an ASP (ICER, −$23,587/quality-adjusted life year), PCR with an ASP (ICER, −$19,833/quality-adjusted life year), and PCR without an ASP (ICER, −$21,039/quality-adjusted life year) were other cost-effective options. In the probabilistic analysis, mRDT was dominant and cost-effective in 85.1% of simulations. Importantly, mRDT with an ASP had an 80.0% chance of being cost-effective, while mRDT without an ASP had only a 41.1% chance. In conclusion, our findings suggest that mRDTs are cost-effective for the diagnosis of patients with suspected bloodstream infection and can reduce health care expenditures. Notably, the combination of mRDT and an ASP can result in substantial health care savings.

Cost–effectiveness analysis of ribociclib plus fulvestrant for hormone receptor-positive/human EGF receptor 2-negative breast cancer

Immunotherapy ◽  
2021 ◽  
Author(s):  
Wei Jiang ◽  
Zhichao He ◽  
Tiantian Zhang ◽  
Chongchong Guo ◽  
Jianli Zhao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Hormone Receptor ◽  
Egf Receptor ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cost Effectiveness Ratio ◽  
Hormone Receptor Positive ◽  
The Cost ◽  
Quality Adjusted Life

Aim: To evaluate the cost–effectiveness of ribociclib plus fulvestrant versus fulvestrant in hormone receptor-positive/human EGF receptor 2-negative advanced breast cancer. Materials & methods: A three-state Markov model was developed to evaluate the costs and effectiveness over 10 years. Direct costs and utility values were obtained from previously published studies. We calculated incremental cost–effectiveness ratio to evaluate the cost–effectiveness at a willingness-to-pay threshold of $150,000 per additional quality-adjusted life year. Results: The incremental cost–effectiveness ratio was $1,073,526 per quality-adjusted life year of ribociclib plus fulvestrant versus fulvestrant. Conclusions: Ribociclib plus fulvestrant is not cost-effective versus fulvestrant in the treatment of advanced hormone receptor-positive/human EGF receptor 2-negative breast cancer. When ribociclib is at 10% of the full price, ribociclib plus fulvestrant could be cost-effective.

scholarly journals Cost-effectiveness of psychotherapy for cluster B personality disorders

2010 ◽  
Vol 196 (5) ◽  
pp. 396-403 ◽  
Author(s):  
Djøra I. Soeteman ◽  
Roel Verheul ◽  
Jos Delimon ◽  
Anke M. M. A. Meerman ◽  
Ellen van den Eijnden ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Personality Disorders ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Decision Analytic Model ◽  
Day Hospital ◽  
Payer Perspective ◽  
Cluster B Personality Disorders ◽  
Effective Choice ◽  
The Cost

BackgroundRecommendations on current clinical guidelines are informed by limited economic evidence.AimsA formal economic evaluation of three modalities of psychotherapy for patients with cluster B personality disorders.MethodA probabilistic decision-analytic model to assess the cost-effectiveness of out-patient, day hospital and in-patient psychotherapy over 5 years in terms of cost per recovered patient-year and cost per quality-adjusted life-year (QALY). Analyses were conducted from both societal and payer perspectives.ResultsFrom the societal perspective, the most cost-effective choice switched from out-patient to day hospital psychotherapy at a threshold of €12 274 per recovered patient-year; and from day hospital to in-patient psychotherapy at €113 298. In terms of cost per QALY, the optimal strategy changed at €56 325 and €286 493 per QALY respectively. From the payer perspective, the switch points were at €9895 and €155 797 per recovered patient-year, and €43 427 and €561 188 per QALY.ConclusionsOut-patient psychotherapy and day hospital psychotherapy are the optimal treatments for patients with cluster B personality disorders in terms of cost per recovered patient-year and cost per QALY.

scholarly journals Cost-Effectiveness of Ipilimumab Plus Anti-PD-1 Therapy Versus Ipilimumab Alone in Patients With Metastatic Melanoma Resistant to Anti-PD-(L)1 Monotherapy

2021 ◽  
Vol 11 ◽  
Author(s):  
Ye Peng ◽  
Xiaohui Zeng ◽  
Liubao Peng ◽  
Qiao Liu ◽  
Lidan Yi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Metastatic Melanoma ◽  
Subgroup Analysis ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cost Information ◽  
Payer Perspective ◽  
The Us ◽  
The Cost ◽  
Quality Adjusted Life

ObjectiveThe use of ipilimumab plus anti-PD-1 has recently been shown to significantly improve the survival of patients with metastatic melanoma resistant to anti-PD-(L)1 monotherapy. The study assessed the cost-effectiveness of ipilimumab plus anti-PD-1 therapy in this population from the US payer perspective.Materials and MethodsA Markov model was created based on a retrospective analysis of patients with metastatic melanoma who were resistant to anti-PD-(L)1. Cost information was obtained from the Centers for Medicare and Medicaid Services and literature-based costs. The utility value was derived from the published literature. The results of the model was the total cost, quality-adjusted life-year (QALY), and incremental cost-effectiveness ratio (ICER). The uncertainty of the model was addressed through sensitivity analysis. In addition, we also conducted subgroup analysis.ResultsIpilimumab plus anti-PD-1 provided an improvement of 1.39 QALYs and 2.48 LYs, at a ICER of $73,163 per QALY. The HR of OS was the variable that had the greatest impact on ICER. Compared to ipilimumab, the probability of ipilimumab plus anti-PD-1 being cost-effective was 94% at the WTP of $150,000/QALY. The results of the subgroup analysis showed that the ICER in the majority of the subgroups was less than $150,000/QALY.ConclusionsIpilimumab plus anti-PD-1 was likely to be cost-effective compared to ipilimumab for patients with metastatic melanoma who are resistant to anti-PD-(L)1 at a WTP threshold of 150,000/QALY.

scholarly journals Cost-effectiveness Analysis of Intraoperative Cell Salvage for Obstetric Hemorrhage

2018 ◽  
Vol 128 (2) ◽  
pp. 328-337 ◽  
Author(s):  
Grace Lim ◽  
Vladyslav Melnyk ◽  
Francesca L. Facco ◽  
Jonathan H. Waters ◽  
Kenneth J. Smith
Keyword(s):  
Cost Effectiveness ◽  
High Risk ◽  
Cesarean Delivery ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cell Salvage ◽  
Obstetric Hemorrhage ◽  
Cesarean Deliveries ◽  
The Cost ◽  
Quality Adjusted Life

Abstract Background Cost-effectiveness analyses on cell salvage for cesarean delivery to inform national and societal guidelines on obstetric blood management are lacking. This study examined the cost-effectiveness of cell salvage strategies in obstetric hemorrhage from a societal perspective. Methods Markov decision analysis modeling compared the cost-effectiveness of three strategies: use of cell salvage for every cesarean delivery, cell salvage use for high-risk cases, and no cell salvage. A societal perspective and lifetime horizon was assumed for the base case of a 26-yr-old primiparous woman presenting for cesarean delivery. Each strategy integrated probabilities of hemorrhage, hysterectomy, transfusion reactions, emergency procedures, and cell salvage utilization; utilities for quality of life; and costs at the societal level. One-way and Monte Carlo probabilistic sensitivity analyses were performed. A threshold of $100,000 per quality-adjusted life-year gained was used as a cost-effectiveness criterion. Results Cell salvage use for cases at high risk for hemorrhage was cost-effective (incremental cost-effectiveness ratio, $34,881 per quality-adjusted life-year gained). Routine cell salvage use for all cesarean deliveries was not cost-effective, costing $415,488 per quality-adjusted life-year gained. Results were not sensitive to individual variation of other model parameters. The probabilistic sensitivity analysis showed that at the $100,000 per quality-adjusted life-year gained threshold, there is more than 85% likelihood that cell salvage use for cases at high risk for hemorrhage is favorable. Conclusions The use of cell salvage for cases at high risk for obstetric hemorrhage is economically reasonable; routine cell salvage use for all cesarean deliveries is not. These findings can inform the development of public policies such as guidelines on management of obstetric hemorrhage.

Cost-effectiveness of pedometer-based versus time-based Green Prescriptions: the Healthy Steps Study

2012 ◽  
Vol 18 (3) ◽  
pp. 204 ◽  
Author(s):  
William Leung ◽  
Toni Ashton ◽  
Gregory S. Kolt ◽  
Grant M. Schofield ◽  
Nicholas Garrett ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Community Care ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Related Quality ◽  
Health Related ◽  
The Cost ◽  
Care Costs ◽  
Quality Adjusted Life

This paper reports on the cost-effectiveness of pedometer-based versus time-based Green Prescriptions in improving physical activity and health-related quality of life (EQ-5D) in a randomised controlled trial of 330 low-active, community-based adults aged 65 years and over. Costs, measured in $NZ (NZ$1 = A$0.83, December 2008), comprised public and private health care costs plus exercise-related personal expenditure. Based on intention-to-treat data at 12-month follow up, the pedometer group showed a greater increase in weekly leisure walking (50.6 versus 28.1 min for the time-based group, adjusted means, P = 0.03). There were no significant between-group differences in costs. The incremental cost-effectiveness ratios, for the pedometer-based versus time-based Green Prescription, per 30 min of weekly leisure walking and per quality-adjusted life year were, (i) when including only community care costs, $115 and $3105, (ii) when including only exercise and community care costs, $130 and $3500, and (iii) for all costs, −$185 and −$4999, respectively. The cost-effectiveness acceptability curves showed that the pedometer-based compared with the time-based Green Prescription was statistically cost-effective, for the above cost categories, at the following quality-adjusted life year thresholds: (i) $30 000; (ii) $30 500; and (iii) $16 500. The additional program cost of converting one sedentary adult to an active state over a 12-month period was $667. The outcomes suggest the pedometer-based Green Prescription may be cost-effective in increasing physical activity and health-related quality of life over 12 months in previously low-active older adults.

scholarly journals Cost-Effectiveness of Serum Galactomannan Surveillance during Mould-Active Antifungal Prophylaxis

2021 ◽  
Vol 7 (6) ◽  
pp. 417
Author(s):  
Ai Leng Khoo ◽  
Ying Jiao Zhao ◽  
Glorijoy Shi En Tan ◽  
Monica Teng ◽  
Jenny Yap ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Antifungal Prophylaxis ◽  
Antifungal Treatment ◽  
Lifetime Horizon ◽  
Old Patients ◽  
Risk Patients ◽  
The Cost ◽  
Quality Adjusted Life

Serial galactomannan (GM) monitoring can aid the diagnosis of invasive aspergillosis (IA) and optimise treatment decisions. However, widespread adoption of mould-active prophylaxis has reduced the incidence of IA and challenged its use. We evaluated the cost-effectiveness of prophylaxis-biomarker strategies. A Markov model simulating high-risk patients undergoing routine GM surveillance with mould-active versus non-mould-active prophylaxis was constructed. The incremental cost for each additional quality-adjusted life-year (QALY) gained over a lifetime horizon was calculated. In 40- and 60-year-old patients receiving mould-active prophylaxis coupled with routine GM surveillance, the total cost accrued was the lowest at SGD 11,227 (USD 8255) and SGD 9234 (USD 6790), respectively, along with higher QALYs gained (5.3272 and 1.1693). This strategy, being less costly and more effective, dominated mould-active prophylaxis with no GM monitoring or GM surveillance during non-mould-active prophylaxis. The prescription of empiric antifungal treatment was influential in the cost-effectiveness. When the GM test sensitivity was reduced from 80% to 30%, as might be anticipated with the use of mould-active prophylactic agents, the conclusion remained unchanged. The likelihood of GM surveillance with concurrent mould-active prophylaxis being cost-effective was 77%. Routine GM surveillance remained cost-effective during mould-active prophylaxis despite lower IA breakthroughs. Cost-saving from reduced empirical antifungal treatment was an important contributing factor.

scholarly journals Sequencing Systemic Therapy Pathways for Advanced Hepatocellular Carcinoma: A Cost Effectiveness Analysis

Liver Cancer ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 549-562
Author(s):  
Christopher Sherrow ◽  
Kristopher Attwood ◽  
Kehua Zhou ◽  
Sarbajit Mukherjee ◽  
Renuka Iyer ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cost Effectiveness Analysis ◽  
Advanced Hepatocellular Carcinoma ◽  
Line Treatment ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Quality Adjusted Life

Introduction: Hepatocellular carcinoma (HCC) is the most common form of liver cancer worldwide and carries a poor prognosis. Historically, sorafenib was the only available systemic treatment for advanced HCC. However, in recent years, 6 new treatments have been approved by the US Food and Drug Administration (FDA): regorafenib, lenvatinib, cabozantinib, pembrolizumab, ramucirumab, and nivolumab. Data are lacking regarding the most appropriate sequencing pathway for these agents. Our objective was to conduct a comprehensive cost effectiveness analysis (CEA) of different 1st- and 2nd-line treatment pathways for HCC reflecting all new drug approvals, and then use our data to provide guidance for clinicians on which pathway is the most cost-effective. Materials and Methods: Markov models were used to evaluate the cost effectiveness of 8 different 1st- and 2nd-line treatment sequences. The model allowed for 9 possible states. Cost effectiveness ratios (CER) and incremental CER (ICER) were calculated to compare costs between different pathways and against a willingness-to-pay (WTP) threshold. Efficacy and toxicity data were extracted from the landmark trials for each agent. All agents except ramucirumab were included. The cost of each agent was based on the wholesale acquisition cost (WAC) in USD as of June 2019. Monte-Carlo methods were used to simulate the experience of 1,000,000 patients per treatment sequence for a 12-month period. Results: The pathway with the lowest CER was sorafenib, followed by pembrolizumab (USD 227,741.03/quality-adjusted life year [QALY]). ICER analysis supported implementing 2nd-line pembrolizumab-based pathways at a higher WTP threshold of 300,000/quality-adjusted life year. Sensitivity analysis did not substantially change these results. Conclusions: The most cost-effective strategy was 1st-line tyrosine kinase inhibitor therapy followed by 2nd-line immunotherapy. All pathways exceeded a commonly accepted WTP of USD 100–150,000/QALY. Our preliminary results warrant further studies to best inform real-world practices.

scholarly journals The Cost-Effectiveness of Magnetic Resonance Imaging for Patients with Equivocal Neurological Symptoms

1997 ◽  
Vol 13 (1) ◽  
pp. 21-34 ◽  
Author(s):  
Alvin I. Mushlin ◽  
Cathleen Mooney ◽  
Robert G. Holloway ◽  
Allan S. Detsky ◽  
David H. Mattson ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cost Effectiveness ◽  
Magnetic Resonance ◽  
Incremental Cost ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Neurological Symptoms ◽  
Resonance Imaging ◽  
The Cost ◽  
Quality Adjusted Life

AbstractObjective: To determine the incremental cost-effectiveness of magnetic resonance imaging (MRI) and computed tomography (CT) in young adults presenting with equivocal neurological signs and symptoms. Designs and methods: A decision analysis of long-term survival using accuracy data from a diagnostic technology assessment of MRI and CT in patients with suspected multiple sclerosis, information from the medical literature, and clinical assumptions. Main results: In the baseline analysis, at 30% likelihood of an underlying neurologic disease, MRI use has an incremental cost of $101,670 for each additional quality-adjusted life-year saved compared with $20,290 for CT use. As the probability of disease increases, further MRI use becomes a cost-effective alternative costing $30,000 for each quality-adjusted life-year saved. If a negative MRI result provides reassurance, the incremental costs of immediate MRI use decreases and falls below $25,000 for each quality-adjusted life-year saved no matter the likelihood of disease. Conclusions: For most individuals with neurological symptoms or signs, CT imaging is cost-effective while MR imaging is not. The cost-effectiveness of MRI use, however, improves as the likelihood of an underlying neurological disease increases. For selected patients who highly value diagnostic information, MRI is a reasonable and cost-effective use of medical resources when even the likelihood of disease is quite low (5%).

scholarly journals Cost-effectiveness Analysis of Preoperative Screening Strategies for Obstructive Sleep Apnea among Patients Undergoing Elective Inpatient Surgery

2020 ◽  
Vol 133 (4) ◽  
pp. 787-800 ◽  
Author(s):  
Ashwin Sankar ◽  
Peter R. Dixon ◽  
Lavarnan Sivanathan ◽  
Stavros G. Memtsoudis ◽  
John R. de Almeida ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cost Effectiveness ◽  
Sleep Apnea ◽  
Incremental Cost ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Incremental Cost Effectiveness Ratio ◽  
Obstructive Sleep ◽  
The Cost ◽  
Quality Adjusted Life

Background Obstructive sleep apnea is underdiagnosed in surgical patients. The cost-effectiveness of obstructive sleep apnea screening is unknown. This study’s objective was to evaluate the cost-effectiveness of preoperative obstructive sleep apnea screening (1) perioperatively and (2) including patients’ remaining lifespans. Methods An individual-level Markov model was constructed to simulate the perioperative period and lifespan of patients undergoing inpatient elective surgery. Costs (2016 Canadian dollars) were calculated from the hospital perspective in a single-payer health system. Remaining model parameters were derived from a structured literature search. Candidate strategies included: (1) no screening; (2) STOP-Bang questionnaire alone; (3) STOP-Bang followed by polysomnography (STOP-Bang + polysomnography); and (4) STOP-Bang followed by portable monitor (STOP-Bang + portable monitor). Screen-positive patients (based on STOP-Bang cutoff of at least 3) received postoperative treatment modifications and expedited definitive testing. Effectiveness was expressed as quality-adjusted life month in the perioperative analyses and quality-adjusted life years in the lifetime analyses. The primary outcome was the incremental cost-effectiveness ratio. Results In perioperative and lifetime analyses, no screening was least costly and least effective. STOP-Bang + polysomnography was the most effective strategy and was more cost-effective than both STOP-Bang + portable monitor and STOP-Bang alone in both analyses. In perioperative analyses, STOP-Bang + polysomnography was not cost-effective compared to no screening at the $4,167/quality-adjusted life month threshold (incremental cost-effectiveness ratio $52,888/quality-adjusted life month). No screening was favored in more than 90% of iterations in probabilistic sensitivity analyses. In contrast, in lifetime analyses, STOP-Bang + polysomnography was favored compared to no screening at the $50,000/quality-adjusted life year threshold (incremental cost-effectiveness ratio $2,044/quality-adjusted life year). STOP-Bang + polysomnography was favored in most iterations at thresholds above $2,000/quality-adjusted life year in probabilistic sensitivity analyses. Conclusions The cost-effectiveness of preoperative obstructive sleep apnea screening differs depending on time horizon. Preoperative screening with STOP-Bang followed by immediate confirmatory testing with polysomnography is cost-effective on the lifetime horizon but not the perioperative horizon. The integration of preoperative screening based on STOP-Bang and polysomnography is a cost-effective means of mitigating the long-term disease burden of obstructive sleep apnea. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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